Provider Demographics
NPI:1275011637
Name:TRAYNOR, SEAN (PSYD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:TRAYNOR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 CAMINO DIABLO STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-4001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2970 CAMINO DIABLO STE 300
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-4001
Practice Address - Country:US
Practice Address - Phone:925-282-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-29
Last Update Date:2024-11-15
Deactivation Date:2024-10-18
Deactivation Code:
Reactivation Date:2024-11-05
Provider Licenses
StateLicense IDTaxonomies
324500000X
CA35265103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility